The long-term physical health needs of UK military veterans: evaluation of the Op RESTORE health navigation service
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Introduction
The long-term physical health needs of UK veterans have not been well characterised. Veterans often present with physical health issues attributable to their
time in service. Prior to 2016, no dedicated NHS pathway existed to address these needs. Op RESTORE was established in 2016 to provide coordinated, specialist-led care for veterans with service-attributable physical health conditions. This study
describes ten years of service delivery.
Methods
A retrospective, cross-sectional observational analysis of prospectively collected registry data was performed (2016–2025). Data were analysed using descriptive
statistics and statistical comparisons performed against national datasets and between internal sub-cohorts.
Results
A total of 1,794 referrals were recorded. Most patients were male Army veterans and presented a median of 15 years after military discharge. Most pathology was non-
operational and only 11% of 487 veterans with a documented injury setting had injuries related to combat. Musculoskeletal pathology predominated (79% of 1,081 with a confirmed pathway), particularly lower-limb (56%) and spinal injuries (31%). Obesity was highly prevalent (55% of 174 recorded BMIs), exceeding national age-matched rates. Mental health comorbidity was common (69%). 64% required navigation to a new clinical pathway. EQ-5D-5L scores improved significantly between referral and discharge from Op RESTORE (p < 0.001).
Conclusion
Veterans accessing Op RESTORE predominantly present with delayed, chronic musculoskeletal and pain-related morbidity rather than acute combat-related injury. The long interval between military discharge and Op RESTORE presentation highlights a poorly documented and insufficiently monitored progression of service-
related pathology over time. This represents missed opportunities for early identification, prevention, and intervention. The high burden of multimorbidity and
frequent need for specialist triage indicate gaps in standard NHS referral pathways for veterans. Coordinated healthcare navigation addresses unmet need and, in uncontrolled analysis, was associated with improved quality of life. Improved characterisation and longitudinal monitoring of veteran physical health could inform targeted, preventive, and integrated service models.
The long-term physical health needs of UK veterans have not been well characterised. Veterans often present with physical health issues attributable to their
time in service. Prior to 2016, no dedicated NHS pathway existed to address these needs. Op RESTORE was established in 2016 to provide coordinated, specialist-led care for veterans with service-attributable physical health conditions. This study
describes ten years of service delivery.
Methods
A retrospective, cross-sectional observational analysis of prospectively collected registry data was performed (2016–2025). Data were analysed using descriptive
statistics and statistical comparisons performed against national datasets and between internal sub-cohorts.
Results
A total of 1,794 referrals were recorded. Most patients were male Army veterans and presented a median of 15 years after military discharge. Most pathology was non-
operational and only 11% of 487 veterans with a documented injury setting had injuries related to combat. Musculoskeletal pathology predominated (79% of 1,081 with a confirmed pathway), particularly lower-limb (56%) and spinal injuries (31%). Obesity was highly prevalent (55% of 174 recorded BMIs), exceeding national age-matched rates. Mental health comorbidity was common (69%). 64% required navigation to a new clinical pathway. EQ-5D-5L scores improved significantly between referral and discharge from Op RESTORE (p < 0.001).
Conclusion
Veterans accessing Op RESTORE predominantly present with delayed, chronic musculoskeletal and pain-related morbidity rather than acute combat-related injury. The long interval between military discharge and Op RESTORE presentation highlights a poorly documented and insufficiently monitored progression of service-
related pathology over time. This represents missed opportunities for early identification, prevention, and intervention. The high burden of multimorbidity and
frequent need for specialist triage indicate gaps in standard NHS referral pathways for veterans. Coordinated healthcare navigation addresses unmet need and, in uncontrolled analysis, was associated with improved quality of life. Improved characterisation and longitudinal monitoring of veteran physical health could inform targeted, preventive, and integrated service models.
Date Acceptance
2026-09-29
Citation
BMJ Public Health
ISSN
2753-4294
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Public Health
Copyright Statement
Copyright This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
License URL
Subjects
Armed Conflicts
Patient Navigation
Military veterans
OpRESTORE
Publication Status
Accepted